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Review
. 2006 Oct 7;333(7571):723.
doi: 10.1136/bmj.38917.503056.7C. Epub 2006 Aug 1.

A meta-analysis of the diagnostic performance of the direct agglutination test and rK39 dipstick for visceral leishmaniasis

François Chappuis  1 , Suman Rijal, Alonso Soto, Joris Menten, Marleen Boelaert
Affiliations
Review

A meta-analysis of the diagnostic performance of the direct agglutination test and rK39 dipstick for visceral leishmaniasis

François Chappuis et al. BMJ. .

Abstract

Objective: To compare the performance of the direct agglutination test and rK39 dipstick for the diagnosis of visceral leishmaniasis.

Data sources: Medline, citation tracking, January 1986 to December 2004. Selection criteria Original studies evaluating the direct agglutination test or the rK39 dipstick with clinical visceral leishmaniasis as target condition; adequate reference classification; and absolute numbers of true positive, true negative, false positive, and false negative observations available or derivable from the data presented.

Results: 30 studies evaluating the direct agglutination test and 13 studies evaluating the rK39 dipstick met the inclusion criteria. The combined sensitivity estimates of the direct agglutination test and the rK39 dipstick were 94.8% (95% confidence interval 92.7% to 96.4%) and 93.9% (87.7% to 97.1%), respectively. Sensitivity seemed higher and more homogenous in the studies carried out in South Asia. Specificity estimates were influenced by the type of controls. In phase III studies carried out on patients with clinically suspected disease, the estimated specificity of the direct agglutination test was 85.9% (72.3% to 93.4%) and of the rK39 dipstick was 90.6% (66.8% to 97.9%).

Conclusion: The diagnostic performance of the direct agglutination test and the rK39 dipstick for visceral leishmaniasis is good to excellent and seem comparable.

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Figures

Fig 1
Fig 1
Estimates of sensitivity and specificity (95% confidence intervals) of rK39 dipstick
Fig 2
Fig 2
Estimates of sensitivity and specificity (95% confidence intervals) of direct agglutination test
See this image and copyright information in PMC

Comment in

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